Uptake of oral antivirals for COVID-19

The COVID-19 oral antivirals dispensing data³ were explored by total number of courses as well as patient ethnicity, socioeconomic deprivation quintile, age and gender. Findings are detailed below.

1. More Paxlovid dispensed than molnupiravir

More than 198,000 courses of Paxlovid and molnupiravir were dispensed over the period. Overall, the vast majority (76 per cent) of dispensings were for Paxlovid, with 24 per cent of patients receiving molnupiravir.

Molnupiravir reduced from 35.6 per cent of total dispensings in the first year to 10.6 per cent in 2023.

Number of courses dispensed, by year

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2. Variations between ethnicities in dispensing of COVID-19 antivirals

The vast majority of Paxlovid or molnupiravir courses (152,319; 77.7 per cent) were dispensed to people of European/Other ethnicities, followed by Asian (13,838; 7.0 per cent), Māori (21,952; 11.2 per cent), and Pacific peoples (8031; 4.1 per cent).

When compared to population estimates⁸, proportionately more European/Other people were dispensed COVID-19 oral antivirals than people of all other ethnicities, suggesting inequitable access to these medicines.

Number of courses dispensed, by ethnicity

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3. People in less socioeconomically deprived areas dispensed more Paxlovid or molnupiravir

A higher proportion of people living in the least socioeconomically deprived areas (22.1 per cent; Dep 1) were dispensed Paxlovid or molnupiravir compared with those living in areas of highest socioeconomic deprivation (16.1 per cent; Dep 5).

The proportion of people dispensed COVID-19 oral antivirals decreased with increasing deprivation, suggesting inequitable access to these medicines.

Number of courses dispensed, by socioeconomic deprivation quintile*

* Socioeconomic deprivation is represented on a scale of 1 to 5, where Dep 1 represents people living in areas of least deprivation, and Dep 5 represents people living in areas of highest deprivation.

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4. Highest proportion of dispensings for Paxlovid or molnupiravir among those aged 65–79

Most people who received a dispensing of Paxlovid or molnupiravir were aged 65–79 (100,927; 51.3 per cent), with those aged 80 and over being the next highest user group (48,866; 24.8 per cent) by age band.

This is likely due to these populations being at highest risk of COVID-19 complications, and one of the access criteria age restrictions being set at 65.

Number of courses dispensed, by age band

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5. More women than men dispensed Paxlovid or molnupiravir

Of the almost 200,000 people dispensed either Paxlovid or molnupiravir for treatment of COVID-19 during April 2022 to December 2023, 57 per cent were female and 43 per cent were male.

Number of courses dispensed, by gender

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We cannot tell how many people with COVID-19 were eligible for treatment with oral antivirals but did not receive them, or the reasons for this, as these data are not available.

However, the dispensing data do show variations that are suggestive of inequitable access to Paxlovid and molnupiravir for the treatment of COVID-19:

• Compared to population estimates, proportionately more European/Other people were dispensed COVID-19 oral antivirals than people of all other ethnicities (despite a pro-equity access criteria for Māori and Pacific peoples having been in place since the medicines became available).

• People living in areas of least deprivation were more likely to be dispensed the medicines than those living in areas of higher deprivation, and the proportion of people dispensed COVID-19 oral antivirals decreased with increasing deprivation quintile.